Safe Connections Youth Ambassador Application

Step 1 of 4

Demographics

To strengthen the quality of our programs, please answer the following questions (optional)

Gender

Man/ boy

Trans identified

Woman/ girl

Race

American Indian/ Alaska Native

Asian/ South Asian

Black/ African American

Latina or Latino/ HIspanic

Middle Eastern/ Arab

Native Hawaiian/ Pacific Islander

White/ Caucasian

What grade are you in?

Freshman

Sophomore

Junior

Senior

Inquiries

What school do you go to?

How did you hear about the Safe Connections Youth Ambassadors?

Why do you want to get involved?

Affiliations

Please list any other volunteer, school related or community groups in which you are involved.

Emergency Contact Information (Please list two)

List

Name

Relationship

Address

Phone

Acknowledgement

To be prepared for my experience I will complete the appropriate initial training for the position for which I am applying and will participate in at least 10 related activities a year. I also understand that there will be support from Safe Connections staff throughout my experience. I expect no special benefits or monetary compensation for the services I donate to Safe Connections.